From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review
Neurostimulation | ||||||||||
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First author | Year | Medical problem | Stimulator | Approach | Imaging | Types of stimulation | How to identify the right spot | Study design | Number of cases | Outcome |
Tepper et al. [45] | 2009 | Intractable migraine | Medtronic model 3625 or 3628 | Infrazygomatic approach | Fluoroscopy | Customized, average amplitude, 1.2 V, pulse rate 67 Hz, pulse width 462 μs | Paresthesia with stimulation at the back of the nose and deep in the back of the soft palate | Case only | 11 | 2 pain-free, 3 had pain reduction, 5 had no response, 1 was not stimulated |
Ansarinia et al. [44] | 2010 | Cluster headache | Medtronic model 3625 | Pterygopalatine fossa | Fluoroscopy | Customized, average amplitude, 1.7 V, frequency 88 Hz, pulse width 294 μs | paresthesia with stimulation in the posterior nasopharynx and root of the nose | Case only | 6 | Total 18 CH attacks, complete resolution with SPG stimulation in 11 attacks, partial in 3, no relief in 4. |
Schoenen et al. [41] | 2013 | Cluster headache | ATI SPG stimulator | Pterygopalatine fossa proximate to the sphenopalatine ganglion | CT | Customized, mean frequency 120.4 Hz, mean pulse width 389.7 μs, mean intensity 1.6 mA | X-ray | Randomized controlled | 28 cases, with 3 randomized settings. | Pain relief achieved in 67.1% of full stimulation-treated attacks compared to 7.4% of sham-treated attacks. P < 0.0001 |
Elahi et al. [47] | 2015 | Idiopathic right facial pain | Medtronic model 3378 | The pterygopalatine fossa | Fluoroscopy | 0.5 mV, pulse width 250 – 450 μs, and 40 – 80 Hz | X-ray | Case report | 1 | 2/10 pain on 6-month follow-up |
Meng et al. [88] | 2016 | Cluster headache | Medtronic model 3487A | Pterygopalatine fossa | Fluoroscopy | Bilateral stimulation, right 0-, 1+, 130 Hz, 120 μs, 0.7 V; left 8-, 9+, 130 Hz, 120 μs, 0.8 V | X-ray | Case report | 1 | Headache frequency reduced to once a week, pain level 1/10 at 4 months |
William et al. [46] | 2016 | Idiopathic facial pain, supraorbital neuropathy, hemicrania continua, facial anesthesia dolorosa, occipital neuropathy | Medtronic Subcompact Octrode | SPG | Fluoroscopy | Unknown | X-ray | Case series | 5 | 80% reported sustained facial pain at mean follow-up of 9.6 months. |
Jurgens et al. [42] | 2016 | Cluster headache | Neurostimulator, described in [41] | Pterylopalatine fossa | CT | Customized, applied as soon as the patient feels cluster headache attacks | X-ray | Cohort study. Long-term follow-up from [41] | 33 cases | 61% of patients were either acute responder (>50% relief from moderate or greater pain) or frequency responder (>50% in attack frequency) at 24 months |
Barloese et al. [43] | 2016 | Cluster headache | Neurostimulator, described in [41] | Pterylopalatine fossa | CT | Customized, applied as soon as the patient feels cluster headache attacks | X-ray | Cohort study. Long-term follow-up from [41] | 33 cases | 30% experienced at least 1 episode of complete attack remission (attack-free period exceeding 1 month). |